Insomnia medication indications and prescribing considerations

Pharmacotherapy should not be the sole therapy for insomnia. Cognitive behavioral therapy for insomnia (CBT-I) is the recommended first-line treatment for chronic insomnia. This table is intended to complement individualized decision-making for medication selection; refer to UpToDate topics on insomnia treatment for more detailed discussion.

DORA: dual orexin receptor antagonist; TCA: tricyclic antidepressant; HRA: histamine receptor antagonist; nBZRA: nonbenzodiazepine benzodiazepine receptor agonist; IR: immediate release; ER: extended release; MON: middle of the night; BZRA: benzodiazepine receptor agonist; MRA: melatonin receptor agonist; SAND: serotonergic antidepressant; ASD: antiseizure drug.

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Insomnia medication indications and prescribing considerations